A Socioecological Perspective on Sexual Health Promotion Choices Among Youth At-Risk for and Living with HIV in Los Angeles and New Orleans.

Authors

Curtis Wong, Katherine A Lewis, Alice M Ma, Hailey Valles, Dianna Polanco, Yara Tapia, Manuel A Ocasio, Rhitishah Yuva Raju, Elizabeth M Arnold, Dallas Swendeman, A. T. N. CARES Study Team

Published in

AIDS and behavior. Jul 17, 2026. Epub Jul 17, 2026.

Abstract

Youth in the US remain at high relative risk for HIV and sexually transmitted infections compared to other age groups despite increasing diversity in the available tools to reduce HIV risk through behavioral strategies, biomedical methods, and treatment as prevention. Previous research has shown that acceptability and appeal of prevention methods vary across youth, and over-emphasis on any one strategy may overlook youth's autonomy to make their own informed decisions about their sexual health. We use a socioecological framework to understand factors influencing sexual health promotion choices among youth at-risk for or living with HIV. Youth ages 16-24 years old in Los Angeles and New Orleans participated in a strengths-based coaching intervention in Adolescent HIV Medicine Trials Network (ATN) studies. A total of 257 youth completed a baseline strengths assessment with a coach. We analyzed qualitative strengths assessment coach case notes to understand youth's sexual health promotion preferences and influencing factors across socioecological levels. Participants described 7 types of sexual health promotion strategies: Relationship dynamics; Not sexually active; STI testing; Condom use; PrEP use; PEP use; and HIV Viral suppression. Participants also described factors at intrapersonal, interpersonal, and community levels that impacted their preferred sexual health promotion strategies. Youth at-risk for or living with HIV make informed decisions around their sexual health based on a variety of intersecting factors across socioecological levels. These complex decisions demonstrate youth's autonomy and emphasize the importance of better incorporating patient-centered care within youth's sexual health.

PMID:
42467127
Bibliographic data and abstract were imported from PubMed on 17 Jul 2026.

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